Emergence of Candida auris in Russia.

This paper reports the emergence of Candida auris infections in an intensive care unit at a hospital in Moscow. Forty-nine cases were diagnosed in 2016-2017, and the risk factors and antifungal susceptibilities are described. The 30-day all-cause mortality for 19 bloodstream infections in patients who did not receive appropriate antifungal therapy was 42.1%. Phylogenetic analysis of the internal transcribed spacer and D1-D2 regions and K143R substitution in the ERG11 gene indicated that the studied C. auris strains were of South Asian origin. This first reported series of C. auris infections in Russia demonstrates the rapid dissemination of this species, and the need for international surveillance and control measures.

[Microbial communities in regions of arctic settlements].

The composition and the structure of microbial communities in areas of Arctic settlements were studied. The main attention has been given to microscopic fungi. As result of observation of 5 Arctic regions 117 species of microscopic fungi are revealed in soils and anthropogenic substrates. The identification was carried out with the use ofmycological and molecular genetic methods. Most ofspecies belong to the Ascomycotina. Genus Penicillium is characterized by the most species diversity (24 species). Most offungi are destructors of various materials and potential human pathogens. Dominant species are revealed. The distribution of microorganisms in the living and working areas of polar stations, as well as the adjacent areas are described. Black-colored fungi adapted to unfavorable environment are often the dominated group of microorganisms on soils and anthropogenic substrates. The shaping of soil microbiota was shown to be related to the anthropogenic impact. Considerable similarity of microbial communities composition in the soil and man-made substrates is fixed. As result of mycological analysis of contaminated soils 76 species of microscopic fungi were observed, but 41 species of them (53.9%) were identified in the areas of Arctic polar stations on the man-made materials. These species include the representatives of the genera Alternaria, Aspergillus, Aureobasidium, Chaetomium, Cladosporium, Exophiala, Geomyces, Humicola, Penicillium, Mucor, Phoma, Rhodotorula, Trichoderma and Ulocladium. The obtained data show a significant similarity in species composition of contaminated soils and anthropogenic substrates. Human activity contributes to the distribution of cosmopolitan species, including opportunistic fungi, in the Arctic region. The high numbers of organotrophic bacteria were revealed in soil samples. Some species of microorganisms produce the organic acids in an external environment that promotes the erosion of materials.

[Circulating immune complexes in the diagnosis of allergic reactions of the immune-complex type]. / Tsirkuliruiushchie immunnye kompleksy v diagnostike allergicheskoi reaktsii immunokompleksnogo tipa.

The content of intermediate and small circulating immune complexes (iCIC and sCIC), the classical path of compliment activation (CCA), the concentration of C4 and C3 compliment components as well as the levels of IgM, IgG1, IgG2 and IgG3 in blood serum were examined in patients with atopic rhinitis and rhinoconjunctivitis concomitant with hypersensitivity to the Candida albicans allergen of the immediate and mixed (immediate and delayed) types. A significantly reduced concentration of sCIC, sCIC/iCIC(sCIC/iCIC), CCA and of the C4 content as well as a pronouncedly increased IgM concentration was typical of the patients with the mixed allergic reaction, which made them markedly different from the virtually healthy subjects and from patients with the immediate type of hypersensitivity. The most pronounced differences (p < 0.001) between the group of patients with the mixed type of allergic reaction and two other groups were those related with the sCIC/iCIC ratio index. Considering the study results, it can be assumed that the determination of the sCIC/iCIC could be used as an extra criterion in the laboratory diagnosis of the 3d (immunocomplex) types of allergic reaction as made in patients with atopic rhinitis and rhinoconjunctivitis with hypersensitivity to the C. albicans allergen.

[Mycotic infections in the practice of an intensive care specialist]. / Mikoticheskie infektsii v praktike vracha-reanimatologa.

The authors report their experience gained in intensive care of patients with a grave complication of the underlying diseases: disseminated mycotic infection. Factors of risk of the complication are enumerated, diagnosis and treatment of mycotic involvement in patients of intensive care wards are described.

[Systemic mycoses: therapy with a new antifungal drug diflucan]. / Sistemnye mikozy: terapiia novym antifungal'nym preparatom difliukanom.

A new antifungal drug of systemic action diflucan (Pfizer, USA) has been tried in 10 patients (mean age 35.9 + (-)3.7 years) with various disseminated mycoses. The drug was used in a daily dose 200 mg intravenously or orally for 23.6 + (-)3.3 days. The response was achieved in all the patients with disseminated mycoses caused by yeast fulgi. Side effects were not registered.

[Use of Diflucan in the treatment of chronic and recurrent candidosis with involvement of the esophagus]. / Opyt primeneniia Diflukana v terapii khronicheskikh i retsidiviruiushchikh form kandidoza s porazheniem pishchevoda.

Diflucan was used in 18 patients with chronic and recurrent candidiasis involving esophagus. The drug proved effective and safe. Recurrences were also responsive to diflucan.

[Bronchopulmonary aspergillosis in leukemia patients]. / Bronkholegochnyi aspergillez u bol'nykh leikozami.

Among 180 patients with varying leukemias bronchopulmonary aspergillosis was diagnosed in 4 (2.2%). Further development of the methods for the treatment of the main disease in this category of patients permits prognosing a significant rise in the incidence of bronchopulmonary aspergillosis. The character of the clinical course of this infection and the ways for further improvements of its diagnosis in lifetime of leukemia patients have been considered.

[Brain cryptococcosis in HIV infection]. / Kriptokokkoz golovnogo mozga pri VICh-infektsii.

A 30-year-old female with HIV-infection (AIDS-stage) died with generalized, including meningoencephalitis, infection. Fungi found in the brain were identified as Cryptococcus neoformans. Fungal cells were also found in the lungs and in the necrotic phlegmon of soft tissue i. e. there was a generalized Cryptococcus infection.

[The use of immunoenzyme analysis in the diagnosis of candidiasis in patients with different variants of hemoblastosis]. / Primenenie immunofermentnogo analiza v diagnostike kandidoza u bol'nykh razlichnymi variantami gemoblastozov.

A total of 84 blood sera taken from patients with tumors of the hematopoietic system, among them 63 blood sera from patients with candidiasis and 21 blood sera from patients without symptoms of Candida infection have been tested in the enzyme immunoassay (EIA). This assay has been found suitable for the diagnosis of the visceral forms of candidiasis in patients with acute leukemia and hematosarcoma. EIA has proved to be an inadequate method for the detection of Candida infection in chronic lympholeukemia patients, as well as in patients with acute leukemia and hematosarcoma, suffering from such local forms of candidiasis as candidiasis of the oral cavity.